21ix7

Our two minute talks last week were based on the investigation of abnormal LFTs but we got sidetracked into the interpretation of hepatitis B serology. This was I hope a useful time both for the specifics of understanding HepB serology and the general point of structuring your knowledge in a way which is useful for practical use. When learning a new topic, or revising an old one remember that the way it is structured in the textbook may need translating to make it easier to remember or apply.

Test yourself…which tests are useful for:

Assessing response to Hep B immunisation?

Checking for previous contact with Hep B?

Acute hepB?

Chronic Hep B?

Next is Opportunistic infection (in HIV)

Pneumocystis SYC

Cytomegalovierus AA

Atypical Mycobacteria AA

Kaposi’s MR

Two minutes please. Keep it precise and concise, quote your sources and educate your colleagues.

Last week’s discussion was about waste and how we might address the problem. This week we will discuss Measuring quality of life. Is there such a thing as a life not worth living? B. Farsides, RJ Dunlop BMJ 2001;322:1481-1483.

Next week the Tuesday discussion will be replaced with (by?) a quiz.

Interesting topics

PEG tubes
Aortic stenosis: indications for valve replacement in adults (uptodate)

Pneumocystis jiroveci

MJM

Wardround 14ix7

The two minute talks for next week will be about the appropriate use of investigations in the patient with abnormal LFTs. Tell me how to use and interpret:

Viral tests AA' s successor
autoimmune serology (and metabolic tests if you can fit it in) MR
imaging SYC

The paper for discussion on Tuesday is WASTE IN THE NHS: THE PROBLEM, ITS SIZE, AND HOW WE CAN TACKLE IT. Andrew Moore, Bandolier.

For Tuesday 25th the discussion paper is Measuring quality of life. Is there such a thing as a life not worth living? B. Farsides, RJ Dunlop BMJ 2001;322:1481-1483.

Interesting topics:

Sheffield tables
ETTs - have a look at Ordering and Understanding the Exercise Stress Test by M Darrow.
Aspirin primary prevention there is much written on this, but you have to start somewhere

Wardround 7ix7

The two minute talks for next Friday will be on the Organisms causing community acquired pneumonia and their associated clinical syndromes. Two minutes please on:
Pneumococcus AA
Mycoplasma SYC
Chlamydia (has its name chasnged?)
Legionella MR

The paper for discussion a week on Tuesday will be WASTE IN THE NHS: THE PROBLEM, ITS SIZE, AND HOW WE CAN TACKLE IT. Andrew Moore DSc, Editor of Bandolier.

MJM

Wardround 31viii7

The ophthalmoscope, stethoscope, pulse oximeter, otoscope and sphygmomanometer all explained in less than half an hour...what an achievement. I still remain uncertain about the correct cuff size for a sphyg. The AHA arec quoted as saying Proper cuff size selection is critical to accurate measurement. The bladder length and width of the cuff should be 80% and 40%, respectively, of the arm circumference. Blood pressure measurement errors are generally worse in cuffs that are too small vs those that are too big. That sounds like an audit just waiting to happen.

For next week we will ahve two minute talks on practical procedures:
Blood cultures (including from lines) GAJ
Chest drain insertion AA
LP AW
Ascitic tap AG
Joint aspiration MJM

The paper for discussion this week was What patients want to know about adverse events. Whatever we may think, the people who took part in this study wanted to know just about everything. We may disagree or have reasons why we believe this is impractical, but should not dismiss it out of hand. Try asking a patient "What do you want to know about this treatment?" next time you suggest something.

The paper for discussion on 11 September is....to be decided.

Interesting topics

Haemolysis

MJM